Intensive nutritional supplements can improve outcomes in stroke rehabilitation.
OBJECTIVE
Poor nutrition is a common complication of strokes severe enough to require inpatient rehabilitation. We therefore tested whether intensive nutritional supplements given to undernourished patients from the time of their admission to a specialized stroke rehabilitation service would improve patient outcomes.


METHODS
Randomized, prospective, double-blind, single center study comparing intensive nutritional supplementation to routine nutritional supplementation in 116 undernourished patients admitted to a stroke service. The analysis included the 90% of patients who were not lost to follow-up due to acute or subacute hospitalization (n = 102; 51 in each group). The nutritional supplements are commercially available and Food and Drug Administration approved. The primary outcome variable was change in total score on the Functional Independence Measure (FIM). The secondary outcome measurements included the FIM motor and cognitive subscores, length of stay (taken from day of admission), 2-minute and 6-minute timed walk tests measured at admission and on discharge, and discharge disposition (home/not home).


RESULTS
Patients receiving intensive nutritional supplementation improved more than those on standard nutritional supplements on measures of motor function (total FIM, FIM motor subscore, 2-minute and 6-minute timed walk tests, all significant at p < 0.002). They did not, however, improve on measures of cognition (FIM cognition score). A higher proportion of patients who received the intensive nutritional supplementation went home compared to those on standard supplementation (p = 0.05).


CONCLUSIONS
Intensive nutritional supplementation, using readily available commercial preparations, improves motor recovery in previously undernourished patients receiving intensive in-patient rehabilitation after stroke.
Rabadi
M H
MH
VA Medical Center, 921 NE 13th Street, Oklahoma City, OK 73104, USA. mhrabadi@gmail.com
Coar
P L
PL
Lukin
M
M
Lesser
M
M
Blass
J P
JP
D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology; D019587:Dietary Supplements; D004185:Disability Evaluation; D004311:Double-Blind Method; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D009043:Motor Activity / Q000502:physiology; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011446:Prospective Studies; D020127:Recovery of Function; D012047:Rehabilitation Centers; D012720:Severity of Illness Index; D000071939:Stroke Rehabilitation; D013997:Time Factors